• Is an indicator of current nutritional
    status, reflecting recent weight changes or
    disruption in nutrient intake
  • Most appropriate indicator to use in an
    emergency setting (e.g. due to sudden/sharp
    period of food shortage)
  • Associated with loss of body fat and severe
  • Children are thinner than their comparable
    age group of same height
  • Classified as Moderate or Severe based on
    anthropometry (measurement of the size,
    weight and proportions of the human body),
    biochemistry and clinical assessment
  • Is an indicator of the nutritional status
    overtime; chronically malnourished
    children are shorter (stunted) than their
    comparable age group

Clinical features of malnutrition

  • Marasmus: severe wasting, old man’s face, excess skin hangs around the buttocks, ribs and zygoma bones are
    prominent, scapular blades and extremities (limbs), eyes are sunken

    • Apathetic or irritable, appetite is fairly good, skin is almost normal, hair demonstrates some changes but not as dramatic as in Kwashiorkor, organomegaly is rare (liver and spleen enlargement)
  • Kwashiakor: pitting feet oedema, skin desquamation, hair changes, presence of bilateral pitting oedema (oedema of both feet), moon face
    • Appears adequately nourished due to excess extra cellular fluid, but is very miserable, apathetic
    • Skin changes (dermatosis, flacky paint dermatitis)
    • Hair changes: Silky, straight, sparsely distributed; easily, painlessly pluckable
    • Severe pallor of the conjunctiva, mucous membranes, palms, and soles, loss of skin turgor (dehydration)
    • Organomegaly (liver, spleen) is common
  • Marasmus-kwashiakor: most common form, presents with features of both Marasmus and Kwashiorkor